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0002 JULIE LANE
�� ��� � � ,i - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map V� Parcel �'�};tay O' ARNSTA LE Application ��C GO Health Division , r Date Issued Conservation Division Application Te Planning Dept. Permit FeeQ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address o2 w L L A N (yf u ,' r-X A O 6 S� Village C + Owner 'M lk r�., n Lp6 k Address J << _ L DU ra-} Telephone Permit RequesO A,, r 9(AAf _ � T N S;-A u (A-!,,e r l C e lcy\o ( 9-32 O PL nJ ark--,i C_ a"i S y lc. C.. "A � n lAj ST4L o Se - -a F N S a:N s 10 Q o VC A-1V c �d - S' Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ® Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - Name �L—�A-c.k Telephone Number Csz)rr I k S - 6. Y3 Address �y �x S' License # -7 7 ik 6 17 7 Home Improvement Contractor# U Email jo e re,,/ v Q_, k g i r . Low, Worker's Compensation # V?o rA G /1� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i Town of Barnstable Reguatory. Services >� a v sue. Bionidi�ag Divisioa Tom Perry,Bnadft Counwoner 2DO lain Slue.Hyaock MA.026D1 wwwAgwabarnatabk ioa ns OJE= 50..M62-038 .. Fax: 508 7904130, Pr peaty Owner Must Complete and Siga This Section If Viing ABuilder �,• RO 0 V�/ ,ass Owna-,of the z4ject prop""" hex+ebyatn afire �'}� S u a t�ON vo act on tnybehalL in all matoess relative to work mitho od-bythis bulding Pemit aPPlicati=for. JK LAht' (Atkii **Pool fences and ala=are the respons ryof the app&Canr. Pools are nbtto.be:fiIled-or utlzed'befoie fence's,.msall+ed-.and all-final - i nspectiow are performed and accdpted. SWW= Ovwrx S Ce of Apoimax Q or LA O w •� per, Nam QAVRMS:OWNwEtMMSIOMvw Federal ID#05-0405629 RISE Engineering RlContractoriteglatratlonNob186 MA Contractor Registration No 120979 A division of Thielsch Engineering CT Contractor Registration No 620120 5 Dupont Avenue,South Yarmouth,MA 62664 CONTRACT ONT�w AC^T 4 e_ 11 508-568-1926 X-6613 FAX 508-568-1933 R I S E Page 1 PROGRAM TM CONTRACT re ENTERED INTO BETWEEN FUSE - ENGINEERING CI.C-RCS. ��� THE CUSTOMER FOR WORK AS CUSTOMER PHONE DATE CUENT N WORK ORDER Mary Orme (508)681.5747 06/18/2015 196551 00002 SERVICE STREET- _ ._— --- BILLM STREET 2 Julie Lane 2 Julie Lane SERVICE CITY.STATE,ZIP --_._ - BILLM CITY.STATE.23P Cotuit,MA 02635 Cotuit,MA 02635 JOB DESCRIPTION AIR SEALING:Provide labor and materials to seal areas ofyour home against wasteful,excess air leakage: This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) (10)working hours.A reduction in cubic feet per minute(cfin)of air infiltration will occur,but the actual number of cfin is not guaranteed. $770.00 ATTIC FLAT:Provide labor and materials to install a 6"layer of R-21 Class I Cellulose added to(832)square feet of open attic space. $098.46 ATTIC ACCESS:Provide labor and materials to insulate the back of(l)attic hatch with 2"rigid Thermax board.Weatherstrip the perimeter. $42.50 VENTILATION:Provide labor and materials to install(2)insulated exhaust hose to existing bathroom fan(s). $100.00 VENTILATION:Provide labor and materials to install ventilation chutes in(69)rafter bays to maintain air flow: $240.81 COMMON WALLS:Provide labor and materials to install 2'FSk faced semi-rigid fiberglass board insulation to(39)square feet of common wall area. $129.09 INCENTIVE:RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed.only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$4,000 per calendar year,and an ' incentive of 100%for the Air Sealing measures. For the safety and health of your home's indoor air quality,we will be conducting a blower door diagnostic of the available air flow in your home both before the work is begun,and after the weatherization work is complete.We will also conduct a full assessment of the combustion safety of your heating system and water heater.This has a value of$90 and is at no cost to you. $90.00 OF Federal ID N 06-MS629 RISE Engineering RI Contractor Registration No 6166 MA Contractor Reglatratlon No 120979 A division of Thielsch Engineering CT Contractor Registration No 620120 ;u 5 Dupont Avenue,South Yarmouth,MA 02664 C oNr�A ft/"1V^T 508-568-1926 X-6613 FAX 508-568-1933 , I S E PROGRAM .Page 2 THIS CONTRACT IS ENTERED INTO SEMEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE--.-_ — DATE CLIENTO VMK ORDER Mary Onne (508)681-5747 06/18/2015 196551 00002 SERVICE STREET - BILLING STREET_ 2 Julie Lane 2 Julie Lane _ -_-------...._................. _._ _—_..------- —.._.--- --- -- - ---_- ---- SERVICE CITY,STATE.UP BILLING CITY,STATE,LP - Cotuit,MA 02635 Cotuit,MA 02635 JOB DESCRIPTION Total: $2,370.80 Program Incentive: - $1,993.10 Customer Total: $377.70 WE AGREE HEREBY TO FURNISH SERVICES COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF **'Three Hundred Seventy-Seven&701100 Dollars $377.70 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNP/UD BALANCE AFTER 70 DAYS.BEE REVERSE FOR IMPORTANT INFIDRMATRON ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. 00 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPA ES AUTHORED Sw -RISE EA91nuAng /CUST--' A .MICE - NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE J DAYS SATISFACTORY TO U D�S AND ARE HEREBY ACCEPTED.YOU ARE AUTHORD TO DO THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE i • Offrce of Investigatioxs I Congress Street Suite 1 Of _= Bosun,MA /2114-2I17 www.massgov/dia _ Yorkers' Compensation Insurance Affidavit: Budders/CoutractorsXlectricians/Plwnbers :"Bt Information f ( L PIease Pratt L "hIv Name(Busmess/OrganimdoWk&vidaal): Address: /Sax` /0 City/Stat.0p: �� ;�+ �- Jo?.?7/ Phone#: SD ��� Are yo errrployer? Check the appropriate box: Type of project(r+egaire ft 1. am a employer with Zr) 4. [] I am a general contractor and I employees(full and/or part-time) have hired the sub-contractors 6 ❑New construction 2.❑ I am a-sole proprietor or partner- listed on the attached sheet 7 []Remodeling ship and have no employees These sub-contractors have S. ❑Demolition ° worlang for me in any capacity. employees and have workers' [No workers'comp.msuraoce comp.insurariml g• $addition red.] 5. We are a corporation and its 10.0 Electrical repairs or additions requar 3.❑ I am a homeowner doing all work offices have eaercased their 11.0 Phmlbing repasts or additions ' myself [No workers'comp. right of exemption Per MGL • 12 El f repairs insurance required.]t c. 152,§1(4),and we have no employees-[No workers' II Other �,4,,A ri Z comp.insurance required.] "Any applicant that checks box#1 must also fill out the swdm below showing dad r wod=1 compensation policy mfamd'yn 'Homeownra who submit tm affidmt indicabag dwy ace doing all wo&gad they hum subide conbw=must submit a new atlidavk indicating such. I Contcamrs that check this box must a�bed an additional sheet showing the name of the its and state wbethwor not those eaCtis have ,nployecs ff the sub-consndots have ea�pinyecs,they aaut ptvv�de thru gs�gs•comp.policy»umber I am an er that iss rovidat )wrkers'co �Pb3' P 8 nrpeasation insurance for my ernpbyees Below is the policy and job site :fbnnadon. I rsuranc :Company Name: Airy#or Self-ins-Lic.#: (� _ �!7 p$',Q(,�/ Expiration Date: b Site Address: a' '�`^) Z. �o e City/Stalet4: 60-u, ->!. A4 ttach a copy of the workers'compensation policy declaration page(show*g the policy number and expiration date). ilure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a e up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the farm of a STOP WORK ORDER and a fine ' I up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of •estigations of the DIA for snsurance coverage verification. j hereby cei%6 undw 4fte and penakki Of e ' that the is ormx on provided above is true and correct nature: ne 2ffuial use dimly-. Do nos lvtzte is this area,ln be cvbspletedby cit}t or- Hat official_ :ity or Town: Permit/License# ssuing Authority(circle one): - .Board of Health 2.Building Department K City/Town Clerk 4. Electrical inspector 5.Plumbing Inspector Other 'ontact Person: Phone#: n r, "R,ightfax C3-2 8/4/2014 8:44 :21 AM PAGE 9/022 Fax Server AC o® CERTIFICATE OF LIABILITY INSURANCE 8TE -04.2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ses)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER I CONTACT NA.4F VIVEIROS INS AGCY INC PHONE FAX 140 PLYMOUTH AVE A;C No Ert: I. Nc: FALL RIVER,MA 02723 g °'LR. jACE S)AFFORDING COVERAGE NAIC0 INSURER CAN INSURANCE COMPANY INSURED INSURER RETROFIT INSULATION CORP PO BOX 105 INSURERSEEKONK,MA 02771 INSURER INSUREREINSURER F - COVERAGES CERDFICA NUMBER: REVISION NUMBER, THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN ,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS-AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRR TYPE OF INSURANCE IN R YVVO POLICY NUMBER µr�SU POLICY�y) Im POLICY EXP LIMITS GENERAL LLABILRY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY { OgMAGE TO RENTED CLAIMS-MADE� OCCUR - I PRE LSES Ee oocunence S MED EXP(Any arc person) S PERSONAL&ADV INJURY S GENERAL AGGREGATE S GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP;OP AC-G S [IL ! JECT I Loc i S AUTOMOBILE LIABILITY r MBINED)SMGLELIbflT S ANY AUTO "�� t ALL OWNED SCHEOUIED I- 60CILY INJURY IPer persons) S. AUTOS AUTOS ) BODILY IN.IURY(Per accident) S HIRED AUTOS AJTO,WNED I OpERTy rE E S S UMBRELLA 11.1,40 U OCCUR I EACH OCCURRENCE S EXCESS LIAB 1_1!jA:MS4AADE AGGREGATE S OED . RE—TENlON S S WORKERS COMPENSATION YVC STA7U- ANDEIAPL !�E O P AEUL17R'EXECUTIV Y;N i X -CRY UTA ER OFFICERMIEMBER EXCLUDED N/A 6S62U6 0 _ I El.EACH ACCIDENT $1,000,O00 tr ra datuy m NH I 8 02-2014 08-02-2015 ,fycs-describe under 470$P81$ I E.L.DISEASE-EA EMPLOYEE $1.000,000 DESCWPT!ON CF OPERATIONS bd I El DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPE ION RATS!LOCAT Dia!VENCLES(ALach ACORD 101'AddWonet RerrIerks Schedule,7 more space Is required) THE INSUREDSS MA WORKERS COMPENSATION POLICY AND ITS LIMITED OTHER STATES ENDORSEMENT AUTHORIZES THE PAYMENT OF BENEFITS FOR CLAIMS MADE BY THE INSUREDS MA EMPLOYEES IN STATES OTHER THAN MA. NO AUTHORIZATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN STATES OTHER THAN MA IF THE INSURED HIRES,OR HAS HIRED EMPLOYEES OUTSIDE OF MA. THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA. CERTIFICATE HOLDER CANCELLATION BPI ISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE e 107 HERMES RD SUITE 110 CANCELLED BEFORE THE EXPIRATION DATE THEREOF, MALTA.NY 12020 NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE . POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r ACORD 25 2010105 ©1988-2010 ACORD CORPORATION-All rights reserved. { ) The ACORD name and logo are registered marks of ACORD R_ lop Office of Consumer Affairs and Business Regulation !!►, 10 Park Plaza - Suite 5170 Boston, MassacNsetts 02116 r Home Improvement C **or Registration Registration: 160461 1 C Type: Private Corporation EX „,n 1�_;��.1..., •}_ ••- 1 �l' piration: 7l29/2016 TNt 252915 RETROFIT INSULATION, INC. JOSEPH REILLY P.O. BOX 105 ;,. �.. .�•^t: SEEKONK MA 02771 Update Address and return card.Mark reason for change. • SCA 1 t,,. 20M•05/11 Ej Address Renewal Employment ❑ Lost Card l=%/¢li TQ077949Y.d/8fU(3CR:If�O¢.�C[d:IQ:C/Efldlil�.� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: ;..61 Type: Office of Consumer Affairs and Business Regulation xpiration:,..:7J -2 16' Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 RETROFIT INSULATI6,19,']5( 4 JOSEPH REILLY 644 RODMAN ST ~`1' FALLRIVER,MA 02721 Undersecretary . . of slid without signature �} - �a>3aaC11ttfEtt�-06pertment of PulabbC Safety 1 Boe►sB®f Bubialb ►.g ReguBen3 and Standards Cauctructi6n'suneraieaerSr►ecialt6 4 License CSSL 100T71 tiF 1 1'Y A s 4 • JOS$pli.;i; 1 r RBIQL Seehonk MA`'02771 1 * �.�.� ► .;7rle Expiration Commissioner 06I0512017 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I : Parcel �0 M Application #aQ Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee ` Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation Hyannis Project Street Address Village �Vl — ----- — ' Owrer__ � G�yI UJ _ Address` Z ✓ v`t 1, PL Telephone Permit R quest jr (00S�/�xl-�o� o�� 501A/ �� �, l� � e® - �• Y�— o Nil Square feet: 1 st floor: existing proposed � 2nd,floor: existing —proposed Total new .Zoning District _Flood Plain Groundwater Overlay Project Valuation _ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units)._ Age of Existing Structure Historic House: ❑Yes la On Old King's Highway: ❑Yes �No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other, Basement Finished Area(sq.ft.) — Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: _ existing _new Total ROOr7I Count (not including baths): existing new_ First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing _New _ Existing wood/coal stove: ❑Yos ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing •❑ new size _ Barn isting CTneW;size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size ^ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ _ Commercial ❑Yes #No If yes, site plan review # i.dJ n Current Use Proposed Use 1 - _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Z- / Name _ � Ott r 1� � Telephone Number Address q�t/cl&, License#AGS" /0 �1 4110 Home Improvement Contractor# 92 76 _ Worker's Compensation # 6K U?_q q2?6(6�-f•7 ALL.CONSTRUCTION DEBRIS RESULTI G FR^gM THIS PROJECT WILL BE TAKEN TO �7a Jta 4a.ILL ✓�la SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL x GAS: ROUGH.. FINAL ie FINALBUILDING�. L�°'�tic " f DATE CLOSED OUT s 6 ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents m Office of Investigations ' d 1 Congress Street, Suite 100 - ,�a Boston, MA 02114-2017 SY° www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual) Cotuit Solar LLC Address: P.O. Box 89 City/State/Zip: Cotuit, MA 02635 Phone #: 508-428-8442 Are you an employer? Check the appropriate box: Type of project(required):. 1.❑■ I am a employer with 12 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have, g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance. required.]uired. 5. ❑ We are a corporation and its, 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑'Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1.(4),and we have no employees. [No workers' 13.❑■ Other Solar PV Installation comp. insurance required.] `Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Travellers Insurance Policy#or Self-ins. Lic:#: UB-4988P868-14 Expiration Date: 3726-2015 Job Site Address: 2- 1v k r u t e_ City/State/Zip: Ca rl ,�l`I OZ 63; Attach a copy of the workers' compensation policy-declaration,page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: t� Date: Phone#: 5084288442 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Rightfa,X 1V1-Z -/':Ls:la AM 1JAUL c/vut rax ot:rvrr 71 DATEIAAMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE M%CMIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE RODUCER D THE CERTI C TE OLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement A statement on this certificate does not confer rights to the • certificate holder in lieu of such endorsemen s. PRODUCER CONTACT NAME: DON BUNKER INS AGCY PHONE FAx 51 MILL STREET BLDG F (A/C,No,E4., EMAIL HANOVER,MA 02339 ADDRESS: 73JCD INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVEERSINDEMNII'YCOMPANY.OFAMERICA. COTUIT SOLAR LLC INSURER B: INSURER C. INSURER D•' - 3800 FALMOUTH RD - INSURER E: MARSTON MILLS,MA 02648 INSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TH 6TOC@TTIFYTHATTHEPOUCIFSOFFNSURANCELIST®BF10Yl HAVE BEENISSU®TO THE INSURED NAMED ABOVE FOR THE POLICY PEWDIN=TED.NOTWITHSTANDING ANY REQUIREMENT,TERM ORCONDRiONOFANYCONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAK THE INSURANCE . AFFORDED BY THE POLICIESDESCRIBEDHEREIN ISSUBJECTTOALLTHETERMS,EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVEBEEN REDUCED BY PAM CLAIM DISR ADD SUB POLICVEFFDATE POLICY EXP DATE € LTR TYPE OF CISURANCE- L" R POLICY NUMBER pY2MMYYYY) (UMfDDWYYYY) LRTITS GENERAL LIABILITY [RE CURRENCE. $ COMMERCIAL GENERAL LIABILITY TORENTED S CLAIMS MADE OCCUR. S(Ea=mence) (Any one person) S AL&ADV WJURY S GEN'L AGGREGATE LIMIT APPLIES PER: L AGGREGATE S POLICY 0PROJECT LOC TS-COMP/OPAGG 5 AUM410BILELIABILITY EDSWGLE $_ ANY AUTO LIMIT(Ea acciderd) ALL OWNED AUTOS BODILY INJURY $ " SCHEDULE AUTOS" (Per person) HIRED AUTOS BODILY INJURY �S NON-OWNED AUTOS (Per acciderd) PROPERTY DAMAGE S (Per amdect) ri UMBRELLA LIAR OCCUR. EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE . S DEDUCTIBLE S RETENTIONS EE S AEMPLOYER'S LIABILITY RS NAND YIN U84MOP868-14 0=612014 03126=5 � E UMITSAMORY�OTHER ANY PROPERITORrPARINER(EXECUTIVE y NIA E. �S 500 L EACH ACCIDENT I OFFICERt1EMBEREXCLUDED? ,00D. (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE I S ,500,000 F OPERATIONS Ilelow TI chains DESESCRIPTfON O OF O - - - E.L.DISEASE-POLICY LIMIT S 500,000 .„ DESCRIPTION OF OPERATIONSILOCA710NMEHICL.ESIRESTR=ONSISPECIALITEMS T ffM REPLACES ANY PRIOR CMUgCATE ISSUED TO THE CER7ITICAT E HOLDER AFFECTING IVORKM COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION CONRAD GEYSER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOP,NOTICE WILL BE DELIVERED 3800 F.AL.MOUTH RD IN ACCORDANCE WITH THE POLICY PROVISIONS. AUT}IORRED REPRESENJ 0 MARSTOAT Ma IS,ILIA 02648 ACORD 25 MD1010S3 The ACORD name and logo are registered marks of ACORD 1988-201 D ACORD CORPORATION. All rights reserved. e r i�.jlassaGE3R?SeEFa -:}- er. ra!s 1 L Board of Suildi !ol 4e�'ta13 7o and Le9r?da?ds (•leiS�irttl'L?ttt15?i(1Cs_'ilmatr _`-.' _ 3._iGer ee: CS-107947 t LV; ID JOEIN VREELAN , 1-1 48 QUASENET ROAD .dal ' Mashpee MA 02649 04/25/2018 _ Office of Consumer Affairs.and Business Regulation 10 Park Plaza Suite 5170 Boston, Massachusetts 02116 Home'Improvement Contractor Registration Registration: 146276 -` Type: Supplement Card Expiration: 4/8/2015, COTUIT SOLAR ;..:_ JOHN VREELAND = y 3800 FALMOUTH RD. MARSTONS MILLS, MA 02648 Update Address and return card.Mark reason for c6 SCA 1 0 20M-W11 ❑ Address Renewal Employment n Lo I _Ofrice of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: = Office of Consumer Affairs and Business Regulation Registration 146276- Type: 10 Park Plaza-Suite 5170 Expiration 4/8/2p15' _; Supplement Card Boston,MA 02116 COTUIT SOLAR - JOHN VREELANDAOOL P.O.BOX 89 COTUIT,MA 02635 Undersecretary Not valid without signs ure tic` y Town of Barnstable Regubtoiy Services E �It3PA8J.�; •'. ThomasF Ceiler,;Airector Fo,tA�a1Ifd1Ti LJiEsion Tom Perry, Building Commissioner 2t)O M$n.Strcct;. iiyangs,CV[A OZGt)1 � . www.town barostable.ma us l U€tlee: 50:8-862-40:38 fax= 5084 Q-6234 "roper y Owncr.Must Carn l;ete and: Sign This. Section f Using A Builder as Ovmtrofthe subject proper} e eb a tbO e:. �V d Sa�� e (t V/«��fit to act on.M7 beh in atmGattets.xckiiVe to wotk autkiori�'4d bg this Wld%g p4 wi,t application for ti rA.ddirets of J94) ZA �i�taatur_ �' cz T��te Mal n E VVl-e- pit Nan: I£7Ptopertty:Ovmc r , applying for Debt p mut.c.t m-plate. �e 11'�r�eowttm cerise Excmpdoa ro=.on the revue side, i At Cotuit Solar LLC Project: System: 4.59 kW DC (STC) Site Plan 508-428-8442 Mary Orme 18 Polycrystallyne 255w Modules Revision: December 22, 2015 PO Box 89 2 Julie Lane,Cotuit, 18 Enphase M215 Microinverters scale: COTUIT SOLAR. Cotuit MA 02635 MA 02635 Spe�e.4 ,Spruce Pine Fir w �' . lAswNM �h}'Ip' i Size 2z2d ,_•,�,��„ Grade ►� sx �= - Afeuber T}pe� Rafters tsr►or�oadj •. l Deflection.Limit U3et9 �. w! 0 P .+ {. Spacing(m) _ F EzteriorEzposnre Incised lump � " _ � Snojs Load(psfj 2t3., G Dead Land(psf) Fo' 77.7 ' ....r.M.w�.+'w..+r�e..x.ww .m -• ae:nwM:..vmun+.m'iWu JI/I 004 .p IZte R� HdILTAIItaI Spsu U 3 renmimi ,. F xea e�daf the man br t . . PropertF ' �crT+wJ l""� Ga{r�► ,.~ Species Spm�Ptue-Fn' i Grp :.,a . .. Sizz �4 Owty III 18 solar modules lag bolted into rafters every`4ft. Roof consists of �� affr« > ' Bending sttwgtk(Fb) 2x10 rafters 16" on center spanning a horizontal distance of 11'4"'. Bearing Strength(Fp) 114 ?5 p Maximum allowable horizontal span is 19'9"". shst<�nhc�,,) � , Cotuit Solar LLC Project: S stem: 4.59 kW DC STC Attachment Plan . 508-428-8442 Ma Orme Y ry 18 Polycrystallyrie 255w Modules Revision: December 22, 2014 PO Box 89 2 Julie Lane,Cotuit, 18 Enphase M215 Microinverters Scale: ' w (OTUIT SOLAR«< Cotuit MA 02635 MA 02635 • ��..�—.Speezes �pntce Parse"Fr r,_... ,So4Ht ./yODPAE PRes ¢ TSB' Vwv* CLATV Size 777 �.`. J4�16p Ss !KX Bow' I_.. Gtde777.7777 �i ltiember TypeRafEers(Srsar Laacfj, l-Wx 1 IW9 OFF DeffeEtiaa Latuit T I=Ciftgork)[Lit. Ltd Sank Condi4iaLt? 9keA d� atedorEsposare ` Indset hmbff7 .! ;Snow Load(psf) t� Dead I:aad{psfl iC� A cbM-v. ► " WIMP- « -� 7� • Y P kt� The MA I onz�ant 'Sp T. iR �• v Y M fluters 1G $ +ur i l f�. 9 . 1 kIt 8 BIIItID2llll2lTlf1t11 O � �IIIr J � . a �,��-- °� PReseW�R R�+J6 requyr��t exid<�ftheaz�h+er ..� , »rx ti, ,:w„Ns J SA. G CY �ake o, $ rA Species Sgruc�e Pine-F�r . James A. Clancy, PE Q Csrm e ?;. 601 Asbury Avenue �pR` Stiff National Park, NJ 08063 Massachusetts PE Lic#46775 IN40dahS oa Oasticit�'(E) Bmdi4g Strength(Fb) 18 solar modules lag bolted into rafters every 4ft. Roof consists of Beanug trenQtlt� ps��f 2x10 rafters 16" on center spanning a horizontal distance of 11'4"'. Shear strur Maximum allowable horizontal-span is 19'9"., Cotuit Solar LLC Project: System: 4.59 kW DC (STC) Attachment Plan 508-428-8442 Mary Or me Ju 18 Polycrystallyne 255w Modules Revision: FEBRUARY 4, 2015 PO Box 89 IF l�e,Lane,-C.otul.t, 18 Enphase M215 Microinverters Scale: COTUIT SOLAR,« Cotuit MA 02635 MA 026.35- BARNS TABLE 121 V IS r S F =s. Town of Brgpnstabl67A3L� FSME Tp�� Regulatory Sexvicesp� 1: 4 1 Thomas F.Geiler,Director BARNSeABLFe 9 �. . Building Division 1639. �m PIED MA'S A Tom Perry,Building Corri"gion+ev�_4 200 Main Street, Hyannis,MA 02601 y Office: 508-862-4038 Fax: 508-790-6230 t°171°�d - 00 PERMIT# 0 -7 -FEE: $ chi�J SHED REGISTRATION 120 square feet or less 1,2 � 6--4, 1:� LAjo Location of shed(address) Village. Property owner's name Telephone number Size of Shed Map/Parcel 03 , Signa Date Hyannis Main Street Waterfront Historic District? . Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY APLOT PLAN Q-forms-shedreg REV:121901 ce O �a-b. 5' 6 p' - 0 N o- .x �x - B•0 ,0 y o x , u _ ' 28q 01 27.0 wvo ae SSBgI'45 N Lo Y FLOOD ZONE "C"_ FO UNDA TION CERTIFICA TION RES ZONE.• TO HN-COTUIT- SCALE'1"=40 PL.REF-284 198 ELEV NIA I CERTIFY THAT THE ABOVE YANKEE SURVEY CONSULTANTS FOUNDATION IS LOCATED ON `% OF BOX 265 THE GROUND AS SHOWN, .AND PAUL �, UNIT 1 40 P.O. IT'S POSITION__'DOES i _ " A. ,„ INDUSTRY ROAD CONFORM TO THE ZONING LAW NO.IwItOr ew ti MARSTONS MILLS, MASS. 02648 SETBACK REQUIREMENTS OF TEL• 428—0055 T—..— BARNSTABLE '�FrsTEa�o_ sv FAX 420—5553 --- �Rl 1Ai19 -P ------- JOB nATrl. A/1R/OR i : The Town of Barnstable . mum �,$ Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508- _r&;z -yo3 Ralph Crosse.^ Fax: 508.790-6230 Building Caa:.:.: PLEASE FORWARD THE ATTACHED PAGE(S) TO: TO: ATTN: FAX INO: FROM: DATE: PAGE(S): (EXCLUDING COVER SHEET) 00� _ � , � � (.�L . • 1 BLE WN STA CERTOIFICATE.OFgOFNOCCUPANCY PARCEL ID 021 100 GEOBASE ID 1010 ADDRESS 2 JULIE LAME PHONE COTUIT ZIP - LOT 4 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CT PERMIT 36999 DESC,RIPTION- SINGLE FAMILY DWELLING (PMT.#32808 PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY coNTRACT�RS: Department of Health, Safety ARCHITECTS: y and Environmental Services TOTAL FEES: BOND $.00 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY - MASK. 059. �ED BUI � BY DATE ISSUED 03/11/1999 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU FOR ELECTRICAL,PLUMBING AND M FOR (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. CH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. A i BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 "��•,0 1 ��� 2 /N �:�✓`o�`t� Gi.�3-,j�rE 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 % - ► - ci l j B 0 HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NCV PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TIO . NOTED ABOVE. TION. C j 3�19 9 TOWN OF BARNSTABLE S Y CERTIFICATE OF OCCUPANCY ' PARCEL ID 021 100 GEOBASE ID 1010 ADDRESS 2 JULIE LAgE PHONE COTUIT ZIP - LOT 4 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CT PERMIT 36999 DESCRIPTION' SINGLE FAMILY DWELLING {PMT.#32608 PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 Ox THE CONSTRUCTION 'COSTS $.00 756 CERTIFICATE OF OCCUPANCY +► • 4 * 1ARNSTABLE. + MASS. 039. BUI I1�•�s- BY DATE ISSUED 03/11/1999 EXPIRATION DATE. a« , .► ;; -TOWN OF BARNSTABLE PARCEL ID 021 100 N �G'EOSASZ ID :010 x ADDRESS 2 JULIE LAND , r PHONE COTUIT zip r. LOT �4 �;s. 13166 LOT, SIZE ✓fA qEVE�rZIPMEYT DISTRICT ,'T 'PERMIT 32E308 DESCRIPTION 3BR/2SACAPE/ LL DORM/2 CAR(SEW#9S--611) PERMIT TAPE BUILD TITLE NEW RESIDENTIAL BLDG tPV4T CONTRACTORS:. PROPERTY OWNER - Department of Health, Safety ARcx` and Environmental Services TOTAL FEES. $466.CD INE {CON aT UCTION COSTS_ $160,000. C 101 SINGLE M .HOME DETACI D I:.__. � PRIVATE MAS& r D ;. BUILDING'`DIV S.'Olai '' _ 'BY', :% � DATE, ISSUED 06/19/1-998 EXPIRATION DAT THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF; EITHER TEMPORARILY OR PERMANENTLY. EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE; SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF,OCCU- ELECTRICAL,PLUMBING AND MFOR (READY TO LATH). FANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE: 4.FINAL INSPECTION BEFORE OCCUPANCY. ,! POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 k u G W149 tV 3 1 HEATING INSPECTION APPROVALS NGIN EKING DEPARTMENT 2 3 - i i- 91O� B° � 0 HEALTH 1 / ^ OTHER: SITE PLAN REVIEW APPROVAL PAN WORK SHALL NM PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TIO . NOTED ABOVE. TION. ' - - - S'A R i II I I I I I I I I I I BUILDING PERMIT I G /2 APPROVED �S�- APPROVED- TOWN OF BARNSTABLE TOWN OF BARNSTABLE SAS ❑ WIRING ❑ GAS O'WIRING ,E PLUMBING ❑ BUILDING ❑ PLUMBING ❑ BUILDING 6c,�� � Sz � � � D r(.00►2S Z I 10 v = � � I FT w; yaw 2 a, �3 S'q, r-7 0 2 S 3 7 G `G`.N l� She 6 Gm v n- S—e rq,F-7: 1 l 30 ./Ltd TG o,G`S tf /7 © Tr. s6►�F s G� � �(,a 02 -3 S�.�r L 1ru6 C-L5Jv' =246V L� �- lie �. J 2 � f � rr Engineering Dept.(3rd floor) Map OQ 'r Parcel / :�J�' Permit# 30 House# S Date Issued - ( 1� 9� a4pm Board of Health(3rd floor)(8:15 -9:30/1:00-4-30) e' Conservation Office(4th floor)(00-9:30/1:00' 2:00) SEPTIC M MUST BE Planning Dept.(1st floor/School Admin. Bldg.) C/ TA MPCI�,NCE Definitive Plan Approved by Planning Board �9 _ - ��?19 7 �J ES �-2-e Ce&te j• 3—a;— IP CODE AN® Lz TC CATIONS �C� TOWN OF B STAB Building Permit Application Project Street Address :1 U,1E f Ar1;f- Village * C o T v 'tT �~ } Owner L1;u0 C vRRE6 a24 L a Pow Address "5 -Telephone 44 33 Y 333 (0 :' RX, d aw Y Permit Request ' N E w /t o Arr 6, =: ' :First Floorl //6 square feet Second Floor ( 9® square feet Construction Type W 00 D Estimated Project Cost $ 'r/s-rlJ', o-¢-a ? Zoning District R Flood Plain Water Protection L6t'Si2e-1 A !> D Ac- Grandfathered ❑Yes ❑No `Dwelling Type, Single Family 8""' Two Family ❑ M 11ti-Family(#units) Age of Existing Structure A10AI,6 Historic House ❑;Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: Wfull ❑Crawl ❑Walkout ❑Other `Basement Finished Area(sq.ft.) Md Ai 4: Basement Unfinished Area' (sq.ft) Number of Baths Full: Existing New Half- Existing New No.of Bedrooms: Existing New 3 -A Total Room Count(not including baths): Existing New First Floor Room Count t Heat Typed and FueF 311as ❑Oil ❑Electric ❑Other Central Air ❑Yes p4o- Fireplaces: Existing New f' Existing wood/coal stove ❑Yes U Garage:❑Detached(size) Other Detached Structures? ❑Pool(size) ❑Attached(size) c2 X o / ❑Barn(size) ❑None ❑Shed(size) _ ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ i Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name1 04;A/6 e oif e"Olt A- Telephone Number (-AO/ 3 4 Addrreesns, i L� VO4-L 002, License# CUAtZ EAC C.o¢1✓,8 /0.5=', O A-AB y Home Improvement Contractor# G ENE t o E. C o N'T1t^_'o sL 65 E d C Ra..goi,yE Worker's Compensation#7AS Lo D,3 9 7 2 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 0 _ UI DING PERMIT DENIED FOR THE/FILLOWING REASON(S) I ,. _ FOR OFFICIAL USE ONLY PERMIT NO. 73 Z O DATE ISSUED 'MAP/PARCEL NO. w jo v. ADDRESS VILLAGE _ OWNER DATE OF INSPECTION: FOUNDATION46 FRAME U Go INSULATION 1 "L`� I ,� �,1? . rz t� FIREPLACE _ ELECTRICAL'. ROUGH FINAL - PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL _ FINAL BUILDING 4 DATE CLOSED OIRD C `ASSOCIATION PLAN 1 F+' The Town of Barnstable • seatvsrnsts, • Department of Health Safety and Environmental Services Building Division .367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner PLAN REVIEW Owner: R L Do2� Map/Parcel: (0 Z 1 Project Address: 2 �V Lk t:-:�: L`i Builder: L l t,,I f) The following items were noted on reviewing: ow Spa QS 2�S c�L � L L�:::— �L TS e Please call 508 8624038 for re-inspection. "Spected-by: 1 C� Gib Date: U - k / ' 9 8 q:building:fbms:review 730 CUR Apppdit� Table J=Ib(Continued) Prescriptive Packages for One and Two-Fan*Residential Buildings Anted with Fossil Fueb MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Heating/Cooling Area' U-value= R-value' R-value' R value° Wall Perimeter Equipment Efficiency' Package R value' R value' 5701 to 6500 Hating Degree Days' Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12%- 0.50 38 13 19 10 6 85 AFUE T 15% 036 38 13 2S N/A N/A Normal U 15% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25. N/A N/A 85 AFUE W l5'/- 0.52 30 19 19 l0 6 85 AFUE X 19% 032 38 13 25 N/A N/A Normal Y 19% 0.42 38 19 25 N/A N/A Normal Z 19% 0.42 38 13 19 10 6 90 AFUE AA 18% 0.50 30 19 19 l0 6 90 AFUE 1. ADDRESS OF PROPERTY:: J U l-/E L d4 uf- Lj-oT 1Y 541-Us7• eA Co 7`v/"d'� fr`I,4 T 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: /S-S Lq 3. SQUARE FOOTAGE OF ALL GLAZING:1 a 6 3 4. %GLAZING AREA(#3 DIVIDED BY#2):. /a 74, 5. SELECT PACKAGE(Q--AA-see chart above): 1 C r,..L i•v 6 ere A (14 30 F 6 O :2 /Z v,,-t. .�-� 1�l. o NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a - i 780 CMR Appendix J . Footnotes to Table J5.2.1b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ftZ of decorative glass may be excluded from a building design with 300 ft'of glazing area. 'After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a ' NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 G6 1 t xx C 7 50 5• 0 6,0 0• cr ' �► C• '7. [ 6•0 a o c o x .0' 1 26�.p1 2ti•� cn o _ UND - 68,31 a5"� cl,� Lo . FLOOD ZONE "C"_ FO UNDA TION CERTIFICA TION RES ZONE. "RF" TO WN.•COTUIT SCALE:1"=40 PL.REF.•284 98 ELEV NIA I CERTIFY THAT THE ABOVE YANKEE SURVEY CONSULTANTS FOUNDATION IS LOCATED ON 1% OF P.0. BOX 265 THE GROUND AS SHOWN, AND 4+�' PA �� 4 u4 UNIT 1, OB INDUSTRY ROAD IT'S POSITION__ DOES_ a MARSTONS MILLS MASS. 02648 CONFORM TO THE ZONING LAW Me�w�v y ' � SETBACK REQUIREMENTS OF 0• TEL• 428-0055 , gFcIMST FAX 420—5553 BAR_NSTABLE /O,�AL LAF1OS�� .c-'�e------ JOB PA UL A. MERITHEW DATE. 9�18�98, NUMBER51648 .�""...."`�.-.^•C+n""'ti..ri-e.�...J�r.-.:�.-.�:,r ---`T•..... ;.;,,.. ,._. „. :s•,r.v.✓-^r`y,!'wF-^+v-a.......:-�->+y..:�-;.,;u�.,e�•�j.,.dy y,Jywehr.}-�,{�e�,;l�.lt`�1i.....r,y ts4 -vim. +ir4.�hi•^_ `�tHE Tq, The Town of Barnstable SAE.MASS P y De artment of Health Safety and Environmental Services �. 039, �0 'QED wa+" Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice a Type of Inspection Location 2 ,TJ L,0, - .. Permit Number 00 Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: t7J N Y) \0 r..) _ r 2' boa • 1 . 8. 2w p r Please call: 508-790-6227 for re-inspection. Inspected by ' J Vyiao Date 9 ...++..e.Hr^*+a�.-«�."'+-r.r.).,-r«�.Y^.-...+....+.r......-:.*.-,..+..;t+.=-n+Cf» 'w.:.�..^�""1-....-r"''„ ''�"+—+�"�c'..T'v��' ..::t-ers.JC'kt.'t'4tr•w+'+"-•...s` 3+..y,/`.+':-.,.-r�..;v"r'.-w^".'�-�»,��,-. �1HE►, The Town of Barnstable BARNSTABLE, • Department of Health Safety and Environmental Services MASS. 039 :�°'e Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection .. Location - `-d e Permit Number ? Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: ChadAJ t M 3v 2 ` 6 J N)Se r 0 l.S 2,6 bk(P V- 9* G ,2Q '96 a OIL �o 0Y- Le „�� � ���,s-r �?Yu c�1 ', 1 Q.� �► 6U Vi..' ,Q a te" Ls rz Please call: 508-790-6227 for re-inspection. Inspected by Date ,� i;` -I U i Q fMAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.01 II Checked by/Date CITY: Z �U L , L STATE: Massachusetts HDD: 6333 �J l CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 8-24-1998 COMPLIANCE: PASSES Required UA = 342 Your Home = 267 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value U ---------------------------------------------------------------- ---------- CEILINGS 1130 38.0 38.0 � 1 WALLS: Wood Frame, 16" O.C. 1885 13.0 13.0 9 GLAZING: Windows or Doors 191 0.430 8 DOORS 57 0.430 2 FLOORS: Over Unconditioned Space 1120 19.0 0.0 5 ---------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date MAScheck INSPECTION CHECKLIST jMassachusetts Energy Code . MAScheck Software Version 2.01 DATE: 8-24-1998 Bldg. Dept. Use CEILINGS: [ ] 1. R-38 + R-38 Comments/Location I WALLS: [ ] 1. Wood Frame, 16" O.C. , R-13 + R-13 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.43 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? { ] Yes [ ] No Comments/Location DOORS: [ ] 1. U-value: 0.43 Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2 . Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: ,![ ] Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts shall be insulated per Table J4.4.7. 1. I DUCT CONSTRUCTION: [ ] All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer' s installation, instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4 . I [ ] SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. [ ) HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids . below 55 F must be insulated to the following levels (in. ) : PIPE SIZES (in. ) 1 HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2 .0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2 .0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 [ ] CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in. ) : PIPE SIZES (in. ) NON-CIRCULATING CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F) : RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)------------------------- I r The Commonwealth of Massachusetts Department of Industrial Accidents O1Tice ol/nrekf anions - ._ 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name sII% JD C® "'o location Lo'r city 4 . hone# lo 33 Y 33) ❑ I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one working in any capacity. ///%%%%%%�%//%%%�%/%/%///%O�/%/%%%%/%%%//%/%//////%%%%%%///%%%%//O///%/%%//%////////%%%%/%///%///%%%%////%%%%%%%%%%%%%%�%/�/%%%%%/%�%//%%//%///%/%/, ❑ I am an employer providing workers' compensation for my employees working on this job. compnnv name:1�b U�`T7`f ✓� �/� i.D. L�S 9�E�in✓ address: S cttw /tp ,y�,V AX� �Y�..� phone#- �x.1•� `,t( insurance co. N ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: ' company name 2 /V � 0-"J e.2 T--rL F®2*11 address 'j'Y) �'� U y'! .r.J T � L H' . �0 � Rhone#• �� / � S fl city b I1/U�t 2%'✓� >S�t.4 G l� / C - tj insurance cm olicv# ^'f 'V1J ` //// / //// %%/OG/O////�/• rnmpanv name �f/ address (� cite C'f w er6r�: V i I ) H" phone# .. q in�nr ance co. `� U�` oiicv# oE•3 �k >>:; lt✓S >t:4►ve // .- . Failure to secure coverage as regnire�¢°ander Sec 'on 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to s1,500.00 and/or one years'imprisonment as well as vil penalties' the form of a STOP WORK ORDER and a One of$100.00 a day against me. I understand that a copy of this statementmay a fots+arded to the O ce of Investigations of the DIA for coverage verification. I do hereby ee i der he °outs and pen ies of perjury that the information provided above is true and correct Signature :r Date A —C�r Phone# Print name otllcial use only do not write in this area to be completed by city or town official permit/license f# ❑Building Department city or town: ❑Licensing Board ❑Selectmen's Office ❑check if Immediate response is required ❑Health Department contact person phoned; - ❑Other UrAma 9/95 NA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contras- of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver c tnistee of an individual partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renew. of a license or permit to operate a business or to construct buildings in the commonwealth'for any applicant who ha: not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this'chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed.below. City or Towns Please be sure that the affidavit is cbmplete and printed legibly. The Department has provided a space at the bottom of the 'affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pernirt/license number'which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of imtesilgatlons 600 Washington Street . . Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ISSUE DATE MM/DD/ Y LF C- RCAT i � rS ..ABCDE PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE RYDEN&SULLIVAN OF DENN POLICIES BELOW. O BOX 217 COMPANIES AFFORDING COVERAGE O DENNIS MA 02660 COMPANY A Travelers Insurance Co LETTER COMPANY B INSURED LETTER ENZEL FRAMING, INC. COMPANY C 5 WHIDAH WAY LEITER ENTERV I LLLE, MA 02632 COMPANY D LETTER COMPANY E LETTER :C©VERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQpUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR GTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIrZCAI`E MAY BE ISSUED OR MAY PERTAIN Tr1E INSURANCE AFFi)1tllED BY'THE YOL[CIES DESCRIBEll HERIIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. p POLICY EFFECTIVE POLICY EXPIRATIO TYPE OF INSURANCE POLICY NUMBER LIMITS TR ATE (MM/DD/YY) DATE (MM/DD/YY) GENERAL LIABILITY 6 8 0 2 3 7 J 8 9 2 8 CO F 9 0 6/0 7/9 8 0 6/0 7/9 9 GENERAL AGGREGATE $ 2 , 000,00( OMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ 2 O O O O O LAIMS MADE OCCUR. PERSONAL&ADV.INJURY $ 1 O 0 O O O OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ 1 O O O O O FIRE DAMAGE(Any one fire) $ 300, 000 MED.IXP.(Any one person) $ 5, 000 AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ ___......_......................................__.. ..................... .... ....................................................................................... OTHER THAN UMBRELLA FORM ,; STATUTORY LIMITS WORKER'S COMPENSATION EkCH ACCIDENT AND DISEASE-POLICY LIMIT $ EMPLOYERS'LIABILITY DISEASE-EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEIDCLES/SPECIAL ITEMS CRTIFCATE IiULDER ": CANNCELEA LION . ..: . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO LINO CORREDORA MAIL 3 0 _DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 3 FIELDSIDE DRIVE LEFT,BUT FAILURE TO MAIL SUCH NOTICE IMPOSE NO OBLIGATION OR CUMBERLAND RI 02864 LIABILITY OF ANY KIND UPON THE COMP ,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE i ACORD 25 S{719Q? s ©AC©RD CQRPQ N 149Q: r :::::::::::: ::: DATE M/DD/YY A .FT . .... . ... ........ .... T .. . .. ... .:. .:::::::::::::::::::::::::::::.CORD :: ::::::: :::::::::::::::.:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.::::::::::::::::::::.:::::::::::::::::::::::::::::::::::::::::::::...:.. �. :::::::::.:::::::::: ::.::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.::::.::.... 07 31 1998 ` PRODUCER zz:si::.................................................... ....................................................... / / ::<»:FAX:::;.;:.; .................................................................................:.:.::::::::::. (508)540-2400 (508)540-6671 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE urray & MacDonald Insurance Services HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 406 )ones Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Falmouth, MA 02540 COMPANIES AFFORDING COVERAGE ............................................ COMPANY USF&G Insurance Company Attn: Tara Perry Ext: A ................................................................. ...........................................................>...........................:........................................................................................................................ INSURED COMPANY Alan S. Gardner DBA Gardner Concrete Forms B P.O. Box 98 ..................................................................................................................................................... Monument Beach, MA 02553 COMPANY C ...................:.............................................................................................. ...................... COMPANY D Y :. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INS RED NAMED U ABOVE FOR THE POLICY�PERIOD��• INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .....................................................................................................---.................................................................................................................................................................................................. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR:: DATE(MM/DD/YY) ;' DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 ........................................ ............. .................. X i;COMMERCIAL GENERAL LIABILITY,: PRODUCTS-COMP/OP AGG $ 2,000,000 CLAIMS MADE : X OCCUR: PERSONAL&ADV INJURY : $ 1,000,000 A BFS00000169269 04/29/1998 04/29/1999 :................................ ........ ............................... OWNER'S&CONTRACTOR'S PROT: EACH OCCURRENCE $ 1,000,000 IRE DAM ... .... ...... ........:..................................................... ; F AGE(Any one fire) $ 50,000 MED EXP(Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SI NGLE INGLE LIMIT ANY AUTO ........... - ? ` ..............__........... ............................... ...;... $ ALL OWNED AUTOS i BODILY INJURY $ SCHEDULED AUTOS ,,_... (Per person) In,f U, ......................................... ................................... HIRED AUTOS E s BODILY INJURY'j NON-OWNED AUTOS t r accident)(Pe $ PROPERTY DAMAGE is GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ .......................................... ANY AUTO OTHER THAN AUTO ONLY: ...............................::::::::::::::::::::::::::::::::::::::::. ' EACH ACCIDENT: $ .................................................... AGGREGATE: $ EXCESS LIABILITY EACH OCCURRENCE : $ ........................I................... ........................................ UMBRELLA FORM AGGREGATE $ .................................................................................... OTHER THAN UMBRELLA FORM : $ WORKERS COMPENSATION AND TORYLIMITS .NEW EMPLOYERS'LIABILITY .......................................................... A r, 7717171988 05/01/1998 's 05/01/1999 ..EL EACH ACCIDEN... .._..... $....... .... ............. THE PROPRIETOR/ 100,000 PARTNERS/EXECUTIVE INCL E E..DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: EXCL: EL DISEASE-EA EMPLOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS C. CI[EtG1�TE::hf£[rf)ER:>:»«:<:><::>:«««<:::<:>::>::>:::>::::......:::: ::>; :::<:>?»:>:>: :.... : t+ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDE AMED TO THE LEFT, 'Lino C O r r E d O r a BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO GATION OR LIABILITY 3 Fie 1 d s i d e Drive OF ANY KIND UPON THE Y,ITS AGENTS O E ENTATIVES. C u m b e r l a n d , -RI 02864 AUTHORIZED REPRESEN AO(Tf�#}: :5::�i5 : :»:>::>:»:>:>«:>:>:s>::>:' :::>::«::::::......::>:::>:::>::>:>:>: ::'>«<:::::::::::::>:»::>: :> :::::::>:»::: :: :::::: :z«::::::»>::::::::::>::»»>::»»>:«:> ..:: .: ...................................................................................................................................................................:..::.::::::.::.:::::::::::::::::: �rC3R#)L.' : :; T#OW€9S8 ...............................................................................................................................................................................................................................:................................:....::...:. Restricted To:.00 DEPARTMENT OF PUBLIC SAFETY � CONSTRUCTION SUPERVISOR LICE?1SF, 00 - None Numher:. Expires: 1G 1 D 2 Family Holies. s. CS _ y Restricted To: 00 Failure to possess a current. edition of the Massachusetts State Ruiildina Cod LINO P CORREDORA is cause for revocation of :.his license; .. f ••..� �!"��"'' 3 FIEhDSIDE DR CUHBEP,LAND, RI 02864 r—,—c a , -FT _.- HIE MI H� N Y J T' -- f FRONT ELEVN ION "A' ' - � SCALE pia�1'-O• - .." T - =e.72 SHINCt_ES (oS a=2 SOEc5�� " ` SHINGI_ES'(AS PEQ SPECs�,- -. ' = ` • (o r' !Ci .-,:REAR. ELEVAT l ON s iz T / L'SIDING .e•12� - ... SNING LES (q5 PEQ SPECS l 1 1�p I D Qyt I�NG I _RIG HT S I DE ELEVATION Ij ' SC LE Icy. �I••0. - IJ _ - _ • 1 r A .SNINGI cc Iz � F?'` LP FT .SIDE ELEVATION i woWOOD, EoGK . I G-.Co• I:��e.��'�'- Y. l.�l'� a�� -r s•sen.a-uer 4 f T 4' Y � 6 II �I �' ��I R .. .�� ..•t l--: r .YL 6AT415 ' WKd - OI lo A SW 16, rj 9 2 ?,67C MC - E3 E D Pooe.n i rrr�irr1� -�•p;e � m!� .o o � a � . 2 Z- o„ 2� 13, 2' 2' '� 3' S� a9 6 II A = SI -73/gli�S 11£ — .�!-;p.. K �' �iTl' ..:; BATH•- 1,,,t y-. � -t`J� l •, � s', r" - _. � .. � � � � � - _ T � - �. I ti •. - ,� K�ES a�Or4 ReG^/•�56: (�. N M�CoeJi sOro ,. I Q I:,� �1VGL 4 JCe,UNa4�, Y � :� i I M GL¢9F•ec5 S � �6 SU9•FlnorL 12 lot 12 Ir- _ Y 4 12'SPil,J.-. �I G¢o�.aC.%Etley E7 `o O I .I 6_3 b_.�- � ---�.�. ti �' M- -- - I - I GRreisG E _ - `� I •� :r - (h ry D I I u�_ I I a — _ — _ _ yl � - •I I FOVNDATi O^J PLn�./ 7 EL. = 114' LOCUS TOP OF FYI UNDATION / f 20' MIN. / -- — 10' CONCRETE COVERS m 4" SCHEDULE 40 P. VC / EL 113' MIN. PI7rH 1/.+PER FT "LA/zOF ROAD y • LEWIS POND EL. 112' CONCRETE COVER WASHED S719NE / 4" SCH. 40 PVC / --- (OR EQUAL' MINIMUM RISER C.B. - PIRTCH 1/4 PER FT. 18' 12, 36'MAX CLEAN I SAND \ 9N rn FLO W LINE _ / v INVERT 1 10" SCHOOL STREET I 96 � = 109' MIN 14" INVERT ° ° ° INV. EL=107 °° -zo' /U.POLE \ EL ------ 4'L.L. GAS �s SUM LEVEL ° °° °° ° °° -- / �, \ INVERT II BAFFLE EL.=108,25' INVERT INVERT °o °° ° 8° 108.5 t EL.= 107.5_ EL.= 10_7.25' °.0/ °°8 EL.=10_6_ �) LOCUS / O / (TO BE PLACED ON FLRM BASE)' DISTRIBUTION / MECHANICALLY CN&ACTED OR B" OF STONE BOX �� / GALLONS T O BE WATER TESTED ' X 38' TRENCH FORMATION - 1 0.0 11 PER VIO US SEPTIC TANK IF MORE THAN ONE OUTLET MATERIAL PLACE ON 6" STONE 3i�A H D S921 SOIL ABSORPTION PROFILE OF SYSTEM (SAS) RES. ZONE'' „Rh SEWAGE DISPOSAL SYSTEM BOTTOM OF TEST HOLE NO OBSERVED WATER (7/30/98) ELEV.=__96�0____ NOT TO SCALE PROBABLE WATER TABLE EL. 78�- OFFSETS." / FRONT 30' (USGS TOPO AND CC WATER TABLE CONTOURS) SIDE 15' REAR 15' FLOOD ZONE- "C" ^� 0 / ASSESSORS MAP 21 o O PARCEL 100 PLAN REFERENCE % // 1 2841198 ASSESSORS LOT 1 OBSER VA TION HOLE 1 ELEV. __ 111 - / PERCOLATION RATE < _ MINI INCH A T 48"-i 18"INCHES OBSERVATION HOLE 2 ELE'V. __ IOB_ / W� / g3 O, PERCOLATION RATE <2 _ MINI INCH A T 4B"'t_.L$"INCHES DEPTH HORIZ TEXTURE COLOR OTT. OTHER �TP z �` /38 \�- NO WETLANDS WITHIN 0"-10" A LOAMY SAND 10YR1312 MED.SAND DEPTH HORIZ TEXTURE COLOR' OTT OTHER i l �/ 10"-30" B SAND 10 YR/6/6 FINE/MED. 0"-10" A LOAMY SAND 10 YR/5/2 MED.SAND 500 OF S A. S 10"-30 B SAND IO YR/6/6 FINE/MED. /30"-48" CI SANDVIUMI CCOARSEOEARSE WITH U 30"-48" CI SAND 10 YR7j 6 NONE COARSE 10 YR7/6 NONE i MEDIUM/ 48"-120" C2 SAND 10 YR/B/3 NONE SOME PEBBLES w / 48"-120" C2 SAND 10 YR/8/3 NONE COARSE WITH � SOME PEBBLES zo"-144" C3 SAND 10 YR/8/1 NONE COARSE NO WATER ENCOUNTERED zo'"-144" C3 SAND 10 YR/8/1 NONE COARSE _ —� 112 i NO WATER ENCOUNTERED 2� p=-- TP , SOIL TEST SOIL TEST o - - - - 0 0 / - - - - --�, 10 O � — 5—p 3_B_ED_R_OOM 10 � WILLIAM LEIBERMAN - SOIL EVALUATOR d, -_-HOUSE -2 p N \ DATE OF SOIL TEST 7130/98 SOIL TEST DONE BY / 0 OCp / cr _ - WITNESSED BY: MR. DUNNING B.B. 0.H. EXCAVATOR- TORREY CONSTRUCTION ti o� O, - -_-_ = ASSESSORS 1j� DESIGN CALCULA TIONS. U POLE ti 0 5 2 p -_- - - - LOT 100 B. �� o o =_-- � 4 3,5 78� SQ. FT. \ NUMBER OF BEDROOMS . 3 / - CD--- - - - W \ GARBAGE DISPOSAL . . . . . . . . . NO TA L FL p, - - --_-_- ( I10 EGTAMA BED/DAOY x 3_-- BR.) 330 5_ — — — — — — LEGEND: ( ----- / GAL/DA Y' ( � - _ - - TOP LOAD N - - -__ 267.01 \ 4' STONE SIDES X 38'AND ENDS SOIL CLASSIFICATION . . . . . . . . 1 11 � // 27 p 112 PROPOSED DESIGN PERCOLATION RATE . . . . . < 2 MIN./IN. N 110 CONTOURS EFFLUENT LOADING RATE . . . . . . _ . 74 GAL/DA I/S.F. � � BENCHMARK.: // \ i N / / LEACHING CAPACITY (AREA X RATE) 382 GAL/DA Y EL= 105.3 / `� i RESERVE LEACHING CAPACITY . . . 382 GAL/DA Y (ASSUMED) TOP OF CONCRETE / y1t (38X11X 74)+(38+38+I1+11 X . 74) 9001_____ \ BOUND ,/ ~` /'� ,31'�5 ASSESSORS P NUMBER-_ LOT 101 CA TCH BASIN \\ / rip ,l �� \ old f,J9 WILLIAM UE$ERMAi4 _. ?' \ ram•oo, ♦ \ \ � =_ -=-- �4' ���. ?��t� . GENERAL NOTES y�K ,HSE EYE k i �� r N _ 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. =_= TITLE 5 AND THE TO WN OF BARNSTA RL F.__-_ RULES AND _- REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" PROJECT LOCH T/ON 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF SANTUIT ROAD WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN BARNSTABLE MA. 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL A PPL/CA N T- EE MORTERED IN PLACE. LENO CORREDORA 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VA TION CONTRACTOR YA NKEE SUR VE-Y CONSUL TA N TS IS TO CALL "DIG- SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS P. O. BOX 265 PRIOR TO COMMENCING WORK ON SITE. UNIT 5, 403 /NDUS TR Y ROAD 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS MARSTONS MILLS, MA. 02648 SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. PH. (508)428-0055 — FAX(508)420-5553 8) PARCEL IS IN FLOOD ZONE-_"C"_____. 9) LOT IS SHOWN ON ASSESSORS MAP 21 _ AS PARCEL _100 ISCALE-.' 1"=20' [DA7_E_,- 814198 NOT• TOWN WATER IS AVAILABLE IREV. REV.. JOB NO. 51648 SHEET I OF =1